Background This study compared the current trend in survival rates and morbidity for very low birth weight (VLBW) infants in five Medical Training Centers of Prematurity for the Premature Baby Foundation of Taiwan (PBFT), with the outcomes from the USA, National Institute of Child Health and Human Development Neonatal Research Network (NICHD NRN), the Canadian Neonatal Network (CNN), and the Neonatal Research Network of Japan (NRNJ). Methods The survival rates of {VLBW} infants according to gestational age (GA) and major morbidities were compared between networks (Taiwan, USA, Canada, and Japan). Taiwanese data for {VLBW} infants of {GA} ≤۲۸ weeks between 2007 and 2012 were obtained from the “PBFT Annual Conferences of Premature Care” reports defining survival rate as neonates that survived to the time of discharge. Major morbidities included severe neurological injury (Grade 3 or 4 intraventricular hemorrhage or periventricular leukomalacia), bronchopulmonary dysplasia, severe retinopathy of prematurity, necrotizing enterocolitis, late-onset sepsis, and patent ductus arteriosus. Results The survival rates of {VLBW} infants of {GA} ≤۲۸ weeks from the {PBFT} (Taiwan), {NICHD} {NRN} (USA), {CNN} (Canada), and {NRNJ} (Japan) were 77% (1323/1718), 72% (6859/9575), 82% (2353/2872), and 89% (4489/5069), respectively. The annual survival rates in Taiwan from 2007 to 2012 were 72%, 76%, 76%, 74%, 77%, and 78%, respectively. When {GA} from ≤۲۳ weeks to 28 weeks was assessed in Taiwan, the survival rates of {VLBW} infants according to each week were 22%, 50%, 70%, 80%, 88%, and 92%, respectively. The survival rate, especially at lower GAs, was highest in the {NRNJ} (Japan). The major difference between Taiwan and Japan was attributed to the lower survival rates at lower {GA} (≤۲۶ weeks) in Taiwan. Japan had the lowest rates of major morbidities among the four countries. Conclusion The survival rate of {VLBW} infants has improved over the past 6 years in Taiwan. It is higher than the USA, but lower than Canada and Japan. However, the results from Taiwan are from five Medical Training Centers for the {PBFT} rather than from a population-based study. It is crucial to have a nationwide neonatal research network to develop new practical approaches for {VLBW} infants in Taiwan.